Schedule D.

Form of Recognizance.

Be It Remembered that on the____day of___one thousand eight hundred and____A.B., of____J.K., of____and L.M.. of came personally before us D.E. and F.G., Esquires, Justices of the Peace (or H.J., Resident Magistrate) acting in and for the Province of Otago, and acknowledged themselves to owe to our Sovereign Lady the Queen, to wit, the said A.B. the sum of____pounds, the said J .K. the sum of____pounds, and the said L M. the sum of____pounds, of lawful money of Great Britain, to be respectively levied off their several goods and chattels, lands and tenements, to the use of the said Lady the Queen, her heirs and successors, in case default shall be made in the performance of the conditions hereinafter mentioned.

The conditions of this Recognizanee are such that whereas A.B. is to be licensed pursuant to the "Licensed Hawkers Ordinance 1864" to carry goods, wares, and merchandise for sale by pack-horse (or other animal, or cart or other vehicle, or by boat or other craft as the case may be) within the Province of Otago for a period which will expire on the____day of____next, if the said A.B. shall conform in all respects to the provisions of the aforesaid Ordinance during that period then the said Recognizance to be void. But if the said A.B. shall be lawfully convicted of any offence during the said period against the provisions of the said Ordinance or against the provisions of any other Ordinance in force for the time being relating to Hawkers and Pedlars, then this Recognizance shall remain in full force and effect.

Taken and acknowledged by the above bounden AB., J.K., and L.M., the day____and year first above written.____Before me,

X. Y., J.P.